title: Objective Structured Assessment of Technical Skills (OSATS) evaluation of theoretical versus hands-on training of vaginal breech delivery management: a randomized trial.
abstract: OBJECTIVE
  To compare the skills of performing a vaginal breech (VB) delivery after hands-on training versus demonstration.
  
  
  METHODS
  We randomized medical students to a 30-min demonstration (group 1) or a 30-min hands-on (group 2) training session using a standardized VB management algorithm on a pelvic training model. Subjects were tested with a 25 item Objective Structured Assessment of Technical Skills (OSATS) scoring system immediately after training and 72 h thereafter. OSATS scores were the primary outcome. Performance time (PT), self assessment (SA), confidence (CON), and global rating scale (GRS) were the secondary outcomes. Statistics were performed using the Mann-Whitney U-test, chi-square test, and multiple linear regression analysis.
  
  
  RESULTS
  172 subjects were randomized. OSATS scores (primary outcome) were significantly higher in group 2 (n=88) compared to group 1 (n=84) (21.18±2.29 vs. 20.19±2.37, respectively; p=0.006). The secondary outcomes GRS (10.31±2.28 vs. 9.17±2.21; p=0.001), PT (214.60±57.97 s vs. 246.98±59.34 s; p<0.0001), and CON (3.14±0.89 vs. 2.85±0.90; p=0.04) were also significantly different between groups, favoring group 2. After 72 h, primary and secondary outcomes were not significantly different between groups. In a multiple linear regression analysis, group assignment (odds ratio [OR] 1.60; 95% confidence interval [CI] 1.14-2.05; p<0.0001) and gender (OR 2.91; 95% CI 2.45-3.38; p<0.0001) independently influenced OSATS scores.
  
  
  CONCLUSIONS
  Hands-on training leads to a significant improvement of VB management in a pelvic training model, but this effect was only seen in the short term.
authors.affiliation: Department of Obstetrics and Gynecology, Ruhr University Bochum, Bochum, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Buerkle
authors.forename: Katharina
authors.initials: K
authors.lastname: Rueter
authors.forename: Lukas A
authors.initials: LA
authors.lastname: Hefler
authors.forename: Eva-Katrin
authors.initials: EK
authors.lastname: Tempfer-Bentz
authors.forename: Clemens B
authors.initials: CB
authors.lastname: Tempfer
mesh_terms: D001946:Breech Presentation / Q000628:therapy*; D002983:Clinical Competence; D036861:Delivery, Obstetric / Q000193:education*; D004521:Educational Measurement; D005260:Female; D006801:Humans; D008297:Male; D008953:Models, Anatomic; D011247:Pregnancy; D013337:Students, Medical; D013663:Teaching / Q000379:methods
keywords: Breech; Delivery; OSATS; Randomized; Training; Vaginal breech